What is Coeliac Disease

Coeliac disease (pronounced seel-ee-ak) is an autoimmune disease. Autoimmune means the body mistakenly produces antibodies that damage its own tissues. It is a permanent intestinal intolerance to dietary gluten. A number of serious health consequences can result if the condition is not diagnosed and treated properly.

In those with untreated coeliac disease the mucosa (lining) of the small bowel (intestine) is damaged: The tiny, finger-like projections which line the bowel (villi) become inflamed and flattened. The function of the cells on villi is to break down and absorb nutrients in food. Through a microscope, the lining of the small bowel normally looks rather like shag-pile carpet, the villi making up the “pile”. The entire surface area of a healthy small bowel is comparable in size to that of a tennis court.

In those with untreated coeliac disease, the villi become inflamed and the bowel has a characteristic flat appearance (like a threadbare carpet). This is referred to as villous atrophy. The surface area of the bowel available for nutrient absorption is markedly reduced (to the size of a table or less) which can lead to nutrient deficiencies.

What is the Cause?

In people with coeliac disease the immune system reacts abnormally to gluten, causing small bowel inflammation and damage. Gluten is a protein found in wheat, rye, barley and oats.

Who gets Coeliac Disease?

People are born with a genetic predisposition to develop coeliac disease. They inherit a particular genetic make-up (HLA type) with the genes DQ2 and DQ8 being identified as the “coeliac genes”. Gene testing is presently available through pathology laboratories (by blood test or buccal swab). The gene test is useful for excluding coeliac disease. The presence of HLA DQ2 and HLA DQ8 is not helpful as a positive predictor of coeliac disease, as only 1 in 30 people (approximately) with these genes will have coeliac disease. The gene test cannot diagnose coeliac disease – only exclude it.

Environmental factors also play an important role in the development of coeliac disease.

How Common is the Condition?

Coeliac disease affects approximately 1 in 100 Australians. However 75% currently remain undiagnosed. This means that approximately 157,000 Australians have coeliac disease but don’t yet know it.

Can Coeliac Disease be cured?

People with coeliac disease remain sensitive to gluten throughout their life, so in this sense they are never cured. There is no correlation between symptoms and bowel damage, so even if asymptomatic (you have no symptoms), damage to the small bowel can still occur if gluten is ingested. Once gluten is removed from the diet, the small bowel lining steadily repairs and the absorption of nutrients from food returns to normal.

People with coeliac disease should remain otherwise healthy as long as they adhere to a diet free of gluten. Relapse occurs if gluten is reintroduced.

What are the Long Term Risks of Undiagnosed Coeliac Disease?

The long term consequences of coeliac disease are related to poor nutrition and malabsorption of nutrients. Untreated coeliac disease can lead to chronic poor health, osteoporosis, infertility, miscarriage, depression and dental enamel defects. There is also a small, but real, increased risk of certain forms of cancer such as lymphoma of the small bowel. In children, undiagnosed coeliac disease can cause lack of proper development, short stature and behavioral problems.

For more information download our coeliac disease brochure here. Or contact us to request a copy by mail.